Pregnant-zzzz: Getting the Sleep You Need When You’re Expecting

By Malia Jacobson

Pregnant women are often told to “sleep now, while you can”—but sleeping during pregnancy is easier said than done. Just ask Emily Waggoner, who was surprised to find herself sleepless while pregnant with her daughter, Sarah, now 3.

“Before pregnancy, I would get in bed, fall asleep easily and wake eight hours later,” says Waggoner. That changed around her sixth week of pregnancy, when she started waking multiple times every night. “I was sleepy at work and desperate for uninterrupted sleep.”

Waggoner isn’t alone: Nearly 8 out of 10 pregnant women experience sleep troubles. “The high progesterone in early pregnancy contributes to fatigue, but it also disturbs sleep-wake patterns, so women feel sleepy but they may not be able to sleep well,” says Mary L. Rosser, M.D., Ph.D., an obstetrician and gynecologist with Montefiore Medical Center in New York City.

And sleeping well during pregnancy isn’t just about comfort; a mom’s sleep can affect the health and outcome of her pregnancy. According to a new study, disrupted sleep during pregnancy is linked to preterm births. To help keep you healthy and rested while you’re with child, here are the top pregnancy-related sleep woes, and how to start getting the sleep you need.

Potty Party

Pregnancy increases the workload of the kidneys, which results in one of the earliest symptoms of pregnancy: more frequent urination. Often, these frequent bathroom breaks continue around the clock, interrupting sleep just as newly-pregnant women are feeling more fatigued. “Getting up at night to use the bathroom is one of the most common sleep complaints during pregnancy,” says Dr. Rosser.

For Better Sleep:

Waggoner started experiencing nighttime bathroom trips early in her first trimester. “Eventually, I learned to make it to the bathroom without fully waking up, and that made it easier to get back to sleep,” she says. If nature is calling too frequently at night, Dr. Rosser recommends eliminating caffeine and limiting liquid intake after 6:00 in the evening.

Burning Love

Pregnancy hormones relax the esophagus, so gastric acids can creep up. The resulting heartburn is a nightly trial for many pregnant women, according to obstetrician David E. Zepeda, M.D., of Texas Children’s Hospital. Deborah Flandé of Houston suffered from nighttime heartburn with both of her pregnancies. “I had acid reflux all the way through my pregnancies—the third trimester was the worst,” says Flandé.

For Better Sleep:

To put the brakes on acid indigestion, avoid acidic foods like chocolate, coffee and tomato sauces, especially late in the day. “In general, you want to avoid large meals in the evening if you’re having trouble with heartburn,” says Dr. Rosser. “Eat earlier in the day: Have a large breakfast and lunch, and a lighter dinner.” Sleeping with the upper body elevated—even in a recliner—also can help keep heartburn at bay.

Left Awake

Pregnant women are usually told to sleep on their left side to avoid placing pressure on vital organs and arteries. But for women who aren’t used to sleeping in this position, discomfort and worry can hinder sleep. “Many women are very concerned about sleeping in the correct position, and the stress can make sleep difficult,” Dr. Zepeda says.

For Better Sleep:

While sleeping on the left side is preferred, women don’t need to feel chained to their left side during the night. “In truth, if a woman sleeps on a soft surface, she doesn’t need to be overly concerned about occasionally rolling to her back or right side during sleep. If blood flow is compromised during sleep, the mother will automatically wake up,” says Dr. Zepeda, who notes that in 30 years of practice, he’s delivered more than 8,000 babies and never seen a problem stemming from a mother’s sleeping position.

Legs in Motion

A quarter of pregnant women experience restless legs syndrome, or RLS. Because most of these women didn’t experience RLS before pregnancy, they may not recognize the condition, which causes a creepy-crawly sensation in the extremities (which can include the arms) and a strong urge to move at night. RLS can become worse with each subsequent pregnancy, says Dr. Rosser.

For Better Sleep:

While the cause of RLS is unknown, research has shown that the condition can be related to deficiencies in certain key nutrients, including iron, folate and magnesium. “We know that the vitamins and minerals involved in bone growth and contraction play a role in symptoms of RLS,” Dr. Rosser says. Women should have their physician check their levels of ferritin (stored iron) and continue taking their prenatal supplement daily. Regular exercise and a warm bath before bed also can help keep legs at peace during the night.

Stress Less

Sleep problems can peak during the third trimester, as physical discomfort increases, along with worries about the approaching delivery and imminent parenthood. “Around week 26 or 27, women start to get stressed about the birth, and this can affect their sleep,” Dr. Rosser says.

For Better Sleep:

Often, it’s a fear of the unknown that keeps moms-to-be awake, Dr. Rosser says, so taking a childbirth class can help, especially a group class where moms-to-be can meet other expectant parents. “Anything moms can do to set their minds at ease can help them sleep,” she says.

After a fitful first trimester, Waggoner accepted “her new normal” and started allowing more time for sleep: 10 hours per night instead of eight. “I was a rested, thriving woman again by my second trimester. And it was great training for motherhood.”

Malia Jacobson is an award-winning health and parenting journalist and mom of three. Her latest book is Sleep Tight, Every Night: Helping Toddlers and Preschoolers Sleep Well Without Tears, Tricks, or Tirades.

As always, please consult your health care provider with any questions or concerns.